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目的:对比低位直肠癌采取腹腔镜和传统开放术式根治的临床疗效。方法:回顾性选取我科2011-01-2012-01行手术治疗的低位直肠癌患者共90例,随机将所有患者分为腹腔镜组和开腹组,对比2组患者的手术及术后一般情况、肿瘤根治性、术后并发症发生率和复发率。结果:腹腔镜组患者的手术时间、术中出血量、腹部切口长度、术后排气时间、术后导尿管留置时间、术后进流食时间、术后住院时间、术中或术后输血率和术后应用镇痛剂率显著低于开腹组(P<0.01)。腹腔镜组和开腹组的清扫淋巴结总数、近切缘距离、远切缘距离、环周切缘阴性率和远切缘阴性率差异无统计学意义(P>0.05)。腹腔镜组的术后并发症发生率为6.66%,显著低于开腹组的26.64%(χ2=4.4677,P<0.05)。腹腔镜组和开腹组随访3年的局部复发率、远处转移率和总生存率分别为2.22%、6.66%;8.89%、20.00%;95.56%、82.22%,差异均无统计学意义(P>0.05)。腹腔镜组的无瘤生存率显著高于开腹组(P<0.01)。结论:腹腔镜治疗低位直肠癌创伤小,术后恢复佳,并发症发生率低,同时可降低远期复发率,明显优于开腹手术。
Objective: To compare the clinical efficacy of laparoscopic and traditional open radical mastectomy for low rectal cancer. Methods: A total of 90 patients with low rectal cancer who underwent surgery from January 2011 to January 2012 were retrospectively selected. All patients were randomly divided into laparoscopic group and laparotomy group. The surgery and postoperative complications were compared between the two groups Condition, radical tumor, postoperative complication rate and recurrence rate. Results: The operation time, intraoperative blood loss, abdominal incision length, postoperative exhaust time, postoperative catheter indwelling time, postoperative inflow feeding time, postoperative hospital stay, intraoperative or postoperative blood transfusion The rate of analgesic and rate of postoperative analgesia was significantly lower than that of the open group (P <0.01). There were no significant differences in the total number of lymph nodes, the distance of proximal margin, the distance of distal margin, the negative rate of circumferential margin and the distant margin between laparoscopic group and open group (P> 0.05). The incidence of postoperative complications in laparoscopic group was 6.66%, which was significantly lower than that in open group (χ2 = 4.4677, P <0.05). The local recurrence rate, distant metastasis rate and overall survival rate after 3 years of follow-up in laparoscopic group and open group were 2.22%, 6.66%, 8.89%, 20.00%, 95.56%, 82.22% respectively, with no significant difference P> 0.05). The tumor-free survival rate in laparoscopic group was significantly higher than that in open group (P <0.01). Conclusions: Laparoscopic treatment of low rectal cancer with less trauma, good recovery after surgery, low incidence of complications, and can reduce long-term recurrence rate, significantly better than open surgery.